Company Name / DBA *

Company Type *

Authority Type *

MC # *

DOT # *

SS / Tax ID # *

Do you need a 1099? *

Yes
No

Do you use a factoring company? *

Yes
No

Company Phone # *

Company Fax #

Company Email *

Company Website

Physical Address *

Address Line 1

City

State

Zip Code

Payment / Mailing Address

Address Line 1

City

State

Zip Code

Contacts

Dispatcher Name

Dispatcher Cell #

Dispatcher Email

Accounting Name

Accounting Phone #

Accounting Email

After-hours Name

After-hours Cell #

After-hours Email

Capabilities

Equipment

Specialty Services

Additional Info

Preferred Lanes

Will not go to

Carrier Documents

Upload individual documents or an entire packet using the options below

The following documents are required to get you set up, and booked on loads:

1. MC Authority
2. W-9
3. Certificate of Insurance
4. Notice of Assignment (if any)

Carrier Packet

Upload your company's packet here. Otherwise, upload individual documents below.

OR

MC Authority

Certificate of Insurance

Certificate Holder: ET Transportation Services Inc, PO Box 51, Palermo, ME 04354

W-9

If you need a blank W-9 click here

Notice of Assignment

If you use a factoring company, please attach your Notice of Assignment.

Broker / Carrier Agreement

Click here to download our broker / carrier agreement, sign and upload below.

Signed Broker / Carrier Agreement *